Abstract
BackgroundMost Neonatal Intensive Care Units (NICUs) in China have restricted visiting policies for parents. This also implicates that parents are not involved in the care of their infant. Family Integrated Care (FIC), empowering parents in direct care delivery and decisions, is becoming the standard in NICUs in many countries and can improve quality-of-life and health outcomes of preterm infants. The aim of this study was to evaluate the impact of a FIC intervention on the clinical outcomes of preterm infants with Bronchopulmonary Dysplasia (BPD).MethodsA pre-post intervention study was conducted at NICUs in two Chinese children’s hospitals. Infants with BPD were included: pre-intervention group (n = 134) from December 2015 to September 2016, post-intervention (FIC) group (n = 115) and their parents from October 2016 to June 2017. NICU nurses were trained between July and September 2016 to deliver the FIC intervention, including parent education and support. Parents had to be present and care for their infant minimal three hours a day. The infants’ outcome measures were length-of-stay, breastfeeding, weight gain, respiratory and oxygen support, and parent hospital expenses.ResultsCompared with control group (n = 134), the FIC group (n = 115) had significantly increased breastfeeding rates (83% versus 71%, p = 0.030), breastfeeding time (31 days versus 19 days, p < 0.001), enteral nutrition time (50 days versus 34 days, p < 0.001), weight gain (29 g/day versus 23 g/day, p = 0.002), and significantly lower respiratory support time (16 days versus 25 days, p < 0.001). Oxygen Exposure Time decreased but not significant (39 days versus 41 days p = 0.393). Parents hospital expenses in local Chinese RMB currency was not significant (84 K versus 88 K, p = 0.391).ConclusionThe results of our study suggests that FIC is feasible in two Chinese NICUs and might improve clinical outcomes of preterm infants with BPD. Further research is needed to include all infants admitted to NICUs and should include parent reported outcome measures. Our study may help other NICUs with limited parental access to implement FIC to enhance parental empowerment and involvement in the care of their infant.
Highlights
Most Neonatal Intensive Care Units (NICUs) in China have restricted visiting policies for parents
A total of 319 cases were eligible, of which 58 cases were excluded because parents did not want to participate or were unable to stay for the required hours per day
Our study provides evidence that Family Integrated Care (FIC) might improve the clinical outcomes of infants with Bronchopulmonary Dysplasia (BPD) and could provide a reference for further utilization of FIC in other children’s hospitals in China
Summary
Most Neonatal Intensive Care Units (NICUs) in China have restricted visiting policies for parents This implicates that parents are not involved in the care of their infant. It was found that up to 800 million U.S dollars (USD) in costs are incurred due to preterm infants each year [3], leading to a significantly greater economic burden on their families. These expenses decrease as the number of gestational weeks and birth weight increases [4]. The prolonged hospital stays of preterm infants have a serious impact on familial, social and medical resources [5]
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